Active NPI
Andy W Lee, D.O.
- Emergency Medicine Physician
- Fairfield, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 20A11481
- Practice address
- 1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552 - Phone
- (707) 646-5000
- NPI assigned
- Aug 7, 2007
- Last updated
- Aug 31, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 34.009538 | OH | |
| Emergency Medicine Physician | 207P00000X | 20A11481 | CA | Primary |
Addresses
Primary practice location
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Mailing address
680 Venetian CT
Fairfield, CA 94534-6622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 429-3600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A11481 | CA | MD | Emergency Medicine Physician |
| 34.009538 | OH | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northbay Healthcare Group | Current | Accepting new patients | |
| Northbay Healthcare Group | Current | Accepting new patients | |
| Solano Gateway Medical Group Inc | Emergency Medicine | Current | Accepting new patients |
| Emergency Medicine Physicians of Guernsey County, LTD | Emergency Medicine | Past | Accepting new patients |
Locations
1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600
225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051
1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba dba NorthBay Medical Center
- General Acute Care Hospital
- Fairfield, CA
- NPI 1821147786
-
- Emergency Medicine Physician
- Fairfield, CA
- NPI 1952344293
-
dba NorthBay VacaValley Hospital
- Multi-Specialty Clinic/Center
- Vacaville, CA
- NPI 1760534713
-
- Emergency Medicine Physician
- Cambridge, OH
- NPI 1922047844
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba dba NorthBay Medical Center
- General Acute Care Hospital
- Fairfield, CA
- NPI 1821147786
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314748800000",
"number": "1750572491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 VENETIAN CT",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945346622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 B GALE WILSON BLVD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333552",
"telephone_number": "707-646-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ANDY",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-07",
"last_updated": "2011-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "34.009538",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "20A11481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.